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1 COSTING Of HEALTH SERVICES fOR PROVIDER PAYMENT
https://www.jointlearningnetwork.org/wp-content/uploads/2019/11/JLN_Costing_Manual.pdf
✓ develop the cost accounting model for the analysis. ✓ assess the staff capacity, time, and budgetary needs for data management. ✓ determine the profile of ...
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2 The Challenge of Understanding Health Care Costs and ...
https://journalofethics.ama-assn.org/article/challenge-understanding-health-care-costs-and-charges/2015-11
To patients, cost usually represents the amount they have to pay out-of-pocket for health care services. This cost is very different from the amount that ...
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3 Health Care Cost - an overview | ScienceDirect Topics
https://www.sciencedirect.com/topics/nursing-and-health-professions/health-care-cost
Direct costs consist of the actual costs of delivering the intervention. These include inpatient and outpatient services (which includes professional fees, ...
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4 Your total costs for health care: Premium, deductible, and out ...
https://www.healthcare.gov/choose-a-plan/your-total-costs/
In order to pick a plan based on your total costs of care, you'll need to estimate the medical services you'll use for the year ahead. Of course it's impossible ...
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5 Americans' Challenges with Health Care Costs - KFF
https://www.kff.org/health-costs/issue-brief/americans-challenges-with-health-care-costs/
About four in ten U.S. adults say they have delayed or gone without medical care in the last year due to cost, with dental services being the ...
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6 Welcome to FAIR Health | FAIR Health
https://www.fairhealthconsumer.org/
38 BILLION healthcare claims for 10,000+ services in all areas of the U.S.. About FAIR Health How We Estimate Cost and Quality For Providers Consumer FAQs.
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7 Healthcare Activity-Based Costing: Transforming Cost
https://www.healthcatalyst.com/insights/healthcare-activity-based-costing-transforming-cost
Healthcare activity-based costing (ABC) is the only way to accurately measure and assess 100 percent of an organization's clinical costs and ...
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8 National Health Expenditures 2017 Highlights - CMS
https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/nationalhealthexpenddata/downloads/highlights.pdf
of some high-cost drugs. • Other Health, Residential, and Personal Care Services (5 percent share): Spending for other health, residential, and personal ...
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9 Cost of health services provided at a primary health centre
https://pubmed.ncbi.nlm.nih.gov/7633309/
Results: The total cost incurred for one year was Rs 777,020 (US$ 24,250). Curative care accounted for 32% of the total costs followed by communicable disease ...
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10 The main methodological issues in costing health care services
https://www.york.ac.uk/media/che/documents/papers/researchpapers/rp7_Methodological_issues_in_costing_health_care_services.pdf
the bottom-up method in costing dialysis services in European countries ... of health service costs at the micro-level, including in-patient and outpatient.
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11 Health Costs And Financing: Challenges And Strategies For A ...
https://www.healthaffairs.org/doi/10.1377/hlthaff.2020.01560
Patients now can receive home-based acute care, primary care, and behavioral health services of equal or better quality compared with facility- ...
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12 Quantities and unit prices (cost inputs)
https://www.who.int/teams/health-systems-governance-and-financing/economic-analysis/costing-and-technical-efficiency/quantities-and-unit-prices-(cost-inputs)
WHO-CHOICE uses a health sector perspective for costing, including overhead costs such as programme and training costs as well as patient level service ...
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13 Why does healthcare cost so much? | Blue Cross Blue Shield
https://www.bcbs.com/issues-indepth/why-does-healthcare-cost-so-much
Why does healthcare cost so much? ... Healthcare spending in the United States is $3 trillion a year, straining the budgets of families, businesses and taxpayers ...
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14 Costing Health Services in India—Incremental Steps Towards ...
https://www.cgdev.org/blog/costing-health-services-india-incremental-steps-towards-more-transparent-decision-making
Costing Health Services in India—Incremental Steps Towards More Transparent Decision-Making · Poor cost data can lead to the misallocation of ...
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15 Hill-Burton Free and Reduced-Cost Health Care - HRSA
https://www.hrsa.gov/get-health-care/affordable/hill-burton
Since 1980, more than $6 billion in uncompensated services have been provided to eligible patients through Hill-Burton. Hill-Burton Free or ...
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16 Price setting and price regulation in health care - OECD
https://www.oecd.org/health/health-systems/oecd-who-price-setting-summary-report.pdf
User fee (also user charges, cost-sharing). -. Payment made by a patient to access a service or facility. Voluntary Health Insurance. VHI. Insurance plans where ...
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17 cost of health services in India (CHSI) protocol | BMJ Open
https://bmjopen.bmj.com/content/10/7/e035170
Methods and analysis The CHSI (Cost of Health Services in India) study will collect cost data from 13 Indian states covering 52 public and 40 private hospitals, ...
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18 The Big Idea: How to Solve the Cost Crisis in Health Care
https://hbr.org/2011/09/how-to-solve-the-cost-crisis-in-health-care
Accurate cost measurement in health care is challenging, first because of the complexity of health care delivery itself. A patient's treatment involves many ...
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19 Medical cost trend: Behind the numbers 2022 - PwC
https://www.pwc.com/us/en/industries/health-industries/library/behind-the-numbers.html
Healthcare spending is expected to return to pre-pandemic baselines with some adjustments to account for the pandemic's persistent effects. HRI defines medical ...
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20 Why Do Healthcare Costs Keep Rising? - Investopedia
https://www.investopedia.com/insurance/why-do-healthcare-costs-keep-rising/
Healthcare costs in the United States have been rising for decades and are expected to keep increasing. · The United States spent more than $3.8 trillion on ...
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21 Eight reasons for rising healthcare costs - PeopleKeep
https://www.peoplekeep.com/blog/eight-reasons-for-rising-health-care-costs
According to the Centers for Medicare & Medicaid Services1, in 2021, healthcare costs skyrocketed to $4.3 trillion. Despite the decrease in ...
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22 Developing a standardized healthcare cost data warehouse
https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-017-2327-8
The costing algorithm can create inflation-adjusted standardized costs at the service line level for defined study cohorts on request.
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23 Lowering Healthcare Costs - West Health
https://www.westhealth.org/lowering-healthcare-costs/
The rising cost of healthcare is a growing economic and public health crisis that hurts the U.S. economy, threatens individual financial security, compromises ...
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24 Eight ways to cut your health care costs - MedlinePlus
https://medlineplus.gov/ency/patientinstructions/000870.htm
Learn how to save money and still receive the care you need. Start by looking at your plan information so you know what services are available.
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25 Health Care Costs
https://www.dmhc.ca.gov/healthcareincalifornia/premiumratereview/healthcarecosts.aspx
Contributing Factors to Health Plan Premium Costs ... Health plans determine health care costs by evaluating the price of services and how often those services ...
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26 Explaining Cost Accounting in Healthcare
https://www.stratadecision.com/blog/explaining-cost-accounting-in-healthcare/
Hospitals and health systems represent roughly $1 trillion of the approximately $4 trillion spent annually on U.S. healthcare. They continue to ...
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27 NH Health Cost
https://nhhealthcost.nh.gov/
Compare Health Costs & Quality of Care. ... Compare the estimated cost for outpatient healthcare service in and around New Hampshire by insurance plan.
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28 Healthcare Costs
https://www.ahrq.gov/topics/healthcare-costs.html
Topic: Healthcare Costs ... The Medical Expenditure Panel Survey (MEPS) is a set of large-scale surveys of families and individuals, their medical providers, and ...
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29 Reducing Health Care Spending: What Tools Can States ...
https://www.commonwealthfund.org/publications/fund-reports/2021/aug/reducing-health-care-spending-what-tools-can-states-leverage
These are services that offer patients with certain clinical presentations no benefit, or benefit less than cost, leading to unnecessary ...
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30 Reference Case for Estimating the Costs of Global Health ...
https://researchonline.lshtm.ac.uk/4653001/1/vassall_etal_2018_reference_case_for_estimating_costs_global_health_services.pdf
Throughout this document, we use the term “costing” as a short way to describe the estimation of cost of health interventions or services in a specific context ...
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31 Primary Health Care Costing Tool Development and ...
https://msh.org/projects/phc-costing-tool/
It covers community, health center, and primary hospital services, as well as system management, and produces unit costs for each type of service and total ...
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32 How does cost affect access to care?
https://www.healthsystemtracker.org/chart-collection/cost-affect-access-care/
The Peterson Center on Healthcare and KFF are partnering to monitor how well the U.S. healthcare system is performing in terms of quality and ...
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33 Costs of Caring | AHA - American Hospital Association
https://www.aha.org/costsofcaring
III. Medical Supply and PPE Expenses ... The U.S., like most countries in the world, relies on global supply chains for goods and services. This is especially ...
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34 Health and Economic Costs of Chronic Diseases - CDC
https://www.cdc.gov/chronicdisease/about/costs/index.htm
Learn about the health and economic costs of chronic disease in the US and how preventing or managing symptoms ... Center for Medicare & Medicaid Services.
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35 Transparency and Disclosure of Health Care Prices
https://www.ncsl.org/research/health/transparency-and-disclosure-health-costs.aspx
Moreover, health facilities may set higher prices for certain services than other facilities, raising overall health care costs and spending for payers and ...
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36 The main methodological issues in costing health care services
https://www.semanticscholar.org/paper/The-main-methodological-issues-in-costing-health-A-Mogyor%C3%B3sy-Smith/f99277367642dc6bf732734d2ea181930b5c9e99
In addition, the review summarises the scientific literature on methodologies used in international comparative studies of health service costs at the ...
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37 Cost Reduction Strategies for Health Systems
https://www.compassonehealthcare.com/blog/cost-reduction-strategies-health-systems/
Various healthcare cost reduction strategies can be employed to reduce costs while keeping patients satisfied and maintaining patient outcomes.
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38 METHODS FOR ANALYZING HEALTH CARE UTILIZATION ...
https://www.annualreviews.org/doi/10.1146/annurev.publhealth.20.1.125
Costs above $3000 were truncated at $3000 to make the graph easier to read. The average cost was $390, with a standard deviation of $895. Total costs are more ...
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39 Healthcare Costs and Charges - Sutter Health
https://www.sutterhealth.org/for-patients/health-care-costs-and-charges
As part of this effort, Sutter Health annually publishes hospital chargemaster information and provides an easily accessible online cost estimator tool for ...
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40 Health Care Costing: Data, Methods, Current Applications
https://www.jstor.org/stable/40221961
A second source of difficulties in health care costing is the absence of ... Health and Human Services, including the Agency for Healthcare Research and ...
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41 Total Cost of Care - HealthPartners
https://www.healthpartners.com/about/improving-healthcare/tcoc/
Additional resources · Population-based model · Attributable to medical groups for accountability · Includes all care, treatment costs, places of service, and ...
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42 Estimate Your Out-of-Pocket Costs | University of Utah Health
https://healthcare.utah.edu/pricing/
MyChart also gives estimates for how much you'll pay out-of-pocket for common health care services using your actual insurance information. Get a cost estimate ...
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43 Where can I go to get free or low-cost health care? Is there a ...
https://www.hhs.gov/answers/health-insurance-reform/where-can-i-find-free-or-low-cost-health-care/index.html
You can locate affordable health insurance at the HealthCare.gov Marketplace for coverage. Beware of Health insurance marketplace scams - oig.hhs.gov. But, ...
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44 Health Care Costs - Health Statistics A to Z
https://www.health.pa.gov/topics/HealthStatistics/HealthStatisticsAtoZ/Pages/Health-Care-Costs.aspx
Health Care Costs refer to the monetary cost of various hospital services, expenditures, revenues, operating expenses or other health related expenses such ...
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45 Health Care Cost Institute
https://healthcostinstitute.org/
HCCI is an independent, non-profit organization with leading health care claims datasets that enable research, ... Health Care Cost & Utilization Reports.
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46 5 reasons why healthcare costs are rising
https://www.definitivehc.com/blog/5-reasons-why-healthcare-costs-are-rising
It's no secret that the United States has the most expensive healthcare system in the world. According to a report from the Centers for Medicare and ...
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47 Can cost-effective health care = better health care? | News
https://www.hsph.harvard.edu/news/magazine/winter10assessment/
A: The World Health Organization [WHO] has a rule of thumb: Three times per-person income per quality-adjusted life year gained is a cost-effective intervention ...
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48 Your Healthcare Costs - NYC Health + Hospitals
https://www.nychealthandhospitals.org/your-healthcare-costs/
These services are also referred to as “shoppable services.” This estimated out-of-pocket cost is based on your insurance coverage information or self-pay ...
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49 Home - Health Services Cost Review Commission (HSCRC)
https://hscrc.maryland.gov/Pages/default.aspx
... Maryland's Medicare Total Cost of Care Performance through December 1​, 2022. ... effort to improve care and reduce the growth in healthcare spending.
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50 How State Health Care Cost Commissions Can Advance ...
https://www.americanprogress.org/article/how-state-health-care-cost-commissions-can-advance-affordability-and-equity/
In particular, in the past several years, rising prices for physician and clinical services and for hospital care have contributed significantly ...
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51 Charge, Cost & Price - Brookings Health System
https://www.brookingshealth.org/why-brookings-health/health-care-value/understanding-medical-prices/charge-cost-price
Charge, Cost & Price · To the patient, cost is the amount payable out-of-pocket for healthcare services. · To the health care provider, cost is the expense ( ...
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52 Health Care Cost Transparency Board
https://www.hca.wa.gov/about-hca/who-we-are/health-care-cost-transparency-board
Identifying cost trends and cost drivers in the health care system. Setting a health care cost growth benchmark for providers and payers. Reporting annually to ...
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53 Health System Costs
https://www.nashp.org/policy/health-system-costs/
However, as health care spending continues to rise for consumers and payers—with the largest proportion of those expenditures on hospital services—states ...
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54 A general framework for classifying costing methods for ...
https://link.springer.com/article/10.1007/s10198-019-01157-9
Cost accounting terminology may be unfamiliar to health economists and ... Some countries require healthcare providers to undertake full ...
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55 Why health-care costs are rising in the U.S. more than ... - CNBC
https://www.cnbc.com/2022/02/28/why-health-care-costs-are-rising-in-the-us-more-than-anywhere-else-.html
Health-care spending made up 5% of total U.S. GDP in 1960. In 2020, spending hit almost 20% of total U.S. GDP. “Health care almost always ...
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56 How Much Does Healthcare Cost in the USA?
https://www.internationalinsurance.com/resources/healthcare-costs-in-the-usa.php
Pre-natal care: Your coss. If you require pre-natal care, the average cost of a doctor's visit is between $100 and $2,000+. This adds up ...
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57 Estimate Your Cost of Care | Mission Health
https://missionhealth.org/financial-services/estimate-cost-of-care/
The cost of healthcare is complicated, and understanding things like out-of-pocket expenses and, if you have insurance, how much it will cover for health ...
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58 Costing Methodology and Key Drivers of Health Care Costs ...
https://journals.sagepub.com/doi/full/10.1177/2150132719899763
Mogyorosy and Smith also reviewed methodological issues with costing health care services across Europe in 2005 and highlighted the usefulness of defining cost ...
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59 (PDF) Challenges in Costing Health Care Services
https://www.researchgate.net/publication/235322416_Challenges_in_Costing_Health_Care_Services_Recent_Evidence_from_the_UK
While the outputs of the NRCE are intended to support hospital management and control by facilitating cost benchmarking, the usefulness of NRCE ...
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60 Why Are Americans Paying More for Healthcare?
https://www.pgpf.org/blog/2022/02/why-are-americans-paying-more-for-healthcare
The United States has one of the highest costs of healthcare in the world. In 2020, U.S. healthcare spending reached $4.1 trillion, which ...
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61 Estimates for Out-of-Pocket Costs - Price Transparency
https://www.uofmhealth.org/patient-visitor-guide/estimates-price-transparency
Figuring out what health care is going to cost can be difficult and confusing. Variables include the charge for the service, what your insurance approves and ...
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62 2021 Edition — Health Care Costs 101
https://www.chcf.org/publication/2021-edition-health-care-costs-101/
National health care spending increased 4.6% in 2019 to $3.8 trillion, growing faster than both the economy (4.0%) and consumer prices (1.8%).
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63 Controlling Health Care Costs While Promoting the Best ...
https://www.acponline.org/system/files/documents/advocacy/current_policy_papers/assets/control_hcc_issue_brief.pdf
Healthcare expenditures must be correlated with high quality and efficiency in the delivery of services to improve health outcomes. This requires understanding ...
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64 High and Rising Costs of Health Care in the U.S.
http://www.allhealthpolicy.org/wp-content/uploads/2017/03/Alliance_for_Health_Reform_121.pdf
health care costs, exploring, in depth, two key factors: health care prices, and the volume and intensity of services delivered. ▫ Session 2: Health Care ...
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65 Manage & estimate your health care costs | UnitedHealthcare
https://www.uhc.com/understanding-health-insurance/understanding-health-insurance-costs/manage-your-health-care-costs
Average costs for providers in your network, including doctors, hospitals, office visits, mental health services, labs, convenience care and more. · Average cost ...
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66 Effect of costing methods on unit cost of hospital medical ...
https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1365-3156.2007.01815.x
The process started with a calculation of unit costs of medical services as a base case. ... keywords costing method, unit cost, medical service, hospital.
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67 Costs & Billing for Services Provided at UHS
https://uhs.princeton.edu/using-our-services/costs-billing
If you are a varsity student-athletes or club rugby athlete on the Princeton University Student Health Plan (SHP):. Refer to the SHP Plan Document for the ...
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68 Healthcare Bluebook: Healthcare Price Transparency Solution
https://www.healthcarebluebook.com/
Healthcare Bluebook helps find quality healthcare providers, ... The true quality and cost of healthcare is right in front of you.
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69 Costs of Care at Hennepin Healthcare
https://www.hennepinhealthcare.org/billing/costs-of-care-at-hennepin-healthcare/
Find detailed price information for all services and procedures at Hennepin Healthcare. This information is intended to provide you with cost of care ...
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70 Guidance Document for the Costing of Health Care Resources ...
https://www.cadth.ca/guidance-document-costing-health-care-resources-canadian-setting
CPI, Consumer Price Index ; CSHS, cost of a standard hospital stay ; DAD, Discharge Abstract Database ; FFS, fee-for-service ; IHDA, Interactive Health Data ...
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71 Strategies for Managing Health-Care Costs
https://www.gfoa.org/materials/strategies-for-managing-health-care-costs
It is also possible to set cost-sharing targets for the employer and employee share of medical services and prescription drugs.
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72 Curbing Rising Health Care Costs - SHRM
https://www.shrm.org/hr-today/news/all-things-work/pages/curbing-rising-health-care-costs.aspx
The average per-employee cost of employer-sponsored health ... the cost of health services to plan enrollees—seems to be off the table for ...
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73 Rising health care costs: How California aims to fix them -
https://calmatters.org/health/2022/07/rising-health-care-costs/
She appealed and got financial aid but was still on the hook for $10,000. In 2018, Shelly Tsai, a lawyer with Neighborhood Legal Services Los ...
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74 Understanding Health Care Costs
https://www.muhealth.org/your-visit/billing-insurance-financial-assistance/pricing
Many patients are concerned about the cost of health care services. We understand this uncertainty can be stressful and make it hard to plan your personal ...
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75 Rising Health Care Costs: Causes, Implications, and Strategies
https://www.cbo.gov/sites/default/files/cbofiles/ftpdocs/76xx/doc7665/91-cbo-001.pdf
Although consumers partially pay for their health services through insurance premiums, taxes, and lower direct wages, their decision to use a specific health ...
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76 Your Health Care Costs | Veterans Affairs
https://www.va.gov/health-care/about-va-health-benefits/cost-of-care/
We're committed to providing free health care for conditions related to military service and for Veterans with catastrophic disabilities and ...
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77 The Case Against Fee-for-Service Health Care - Third Way
https://www.thirdway.org/report/the-case-against-fee-for-service-health-care
Determining the actual cost for patients with private insurance is opaque. Private health plans negotiate rates for services with hospitals and ...
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78 How Rising Health Care Costs Are Affecting American ...
https://www.harvardpilgrim.org/hapiguide/how-rising-healthcare-costs-are-affecting-american-consumers/
When it comes to the steady increase in cost of care, there are many factors to consider. In recent years, healthcare spending has seen not only an increase in ...
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79 Administrative Expenses in the US Health Care System
https://jamanetwork.com/journals/jama/fullarticle/2785479
Billing and coding costs, physician administrative activities, and insurance administrative costs are the primary drivers of these expenses. In ...
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80 A dozen facts about the economics of the US health-care system
https://www.brookings.edu/research/a-dozen-facts-about-the-economics-of-the-u-s-health-care-system/
Of course, health costs are also borne by the private sector. ... 3: Most health-care spending is on hospitals and professional services.
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81 Understanding Your Health Care Costs
https://www.wakehealth.edu/patient-and-family-resources/billing-and-insurance/your-health-care-costs
Hospitals have higher costs to provide care than freestanding or retail providers, even for the same type of service. Total Price– The amount actually paid to a ...
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82 Unequal Access to Health Care Costs Us All - TIME
https://time.com/5785945/health-care-problems-america/
The U.S. health care system spent $10,739 per person in 2017, about five times what the country spends on defense and about three times what it ...
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83 Section 1: Minnesota Health Care Spending and Cost Drivers
https://www.health.state.mn.us/data/economics/chartbook/summaries/section1summaries.html
Hospital Care=distribution: 33.3%, spending (in billions): $18.8, growth from 2018: 6.6 percent. Physician Services= distribution: 17.9%, ...
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84 2021 ANNUAL HEALTH CARE COST TRENDS REPORT
https://www.mass.gov/doc/2021-health-care-cost-trends-report/download
MA 2018-2019 spending growth estimate is preliminary. Sources: Centers for Medicare and Medicaid Services, National Healthcare Expenditure Accounts. Personal ...
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85 Cost and Resource Allocation - Frontiers in Health Services
https://www.frontiersin.org/journals/health-services/sections/cost-and-resource-allocation
Part of a multidisciplinary journal, this section addresses problems and issues around the efficient and equitable allocation of healthcare resources and ...
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86 High and Rising Health Care Costs. Part 1 - ACP Journals
https://www.acpjournals.org/doi/full/10.7326/0003-4819-142-10-200505170-00010
Cost-sharing patients had an upper limit on their costs. The study found that patients receiving free care utilized more services and had higher ...
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87 Rate Setting for Health Services: A “Radical” Proposal or A ...
https://sourceonhealthcare.org/rate-setting-for-health-services-a-radical-proposal-or-a-proven-way-to-control-healthcare-costs/
For example, if total costs in the service area are below the target, the hospital would receive a financial bonus, but if total costs in the ...
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88 Calculating the Cost and Financing Needs of the Basic ...
https://www.ghspjournal.org/content/10/4/e2100658
These normative costs are used to calculate the required costs of actual services and the projected costs of scaled-up or modified services. The ...
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89 Three Ways to Lower Health Care Costs
https://www.crfb.org/blogs/three-ways-lower-health-care-costs
Currently, the Medicare program pays higher rates for medical services performed in hospital outpatient departments (HOPDs) than it pays for the ...
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90 Health Care Price Transparency: Meaningful Price Information ...
https://www.gao.gov/products/gao-11-791
GAO defines an estimate of a consumer's complete health care cost as price information on a service that identifies a consumer's ...
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91 Health Care Costs - RAND Corporation
https://www.rand.org/topics/health-care-costs.html
During 2020, prices paid to hospitals by employers and private insurers for both inpatient and outpatient services averaged 224 percent of what Medicare would ...
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92 Direct Health Care Costs, Health Services Utilization, and O...
https://journals.lww.com/jpgn/fulltext/2020/04000/direct_health_care_costs,_health_services.11.aspx
Direct Health Care Costs for Cases and Controls ... The annual median cost of care of BA cases was $4210 (IQR $1091–$16,765) compared to $283 (IQR $112–$634) in ...
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93 How to plan for rising health care costs - Fidelity Investments
https://www.fidelity.com/viewpoints/personal-finance/plan-for-rising-health-care-costs
Learn how you can factor health care costs into your retirement income ... Medicare plan for you with help from Fidelity Medicare Services®.
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94 How Large a Burden are Administrative Costs in Health Care?
https://econofact.org/how-large-a-burden-are-administrative-costs-in-health-care
Estimates suggest that between 15-30 percent of overall health care spending, and one-quarter of the medical labor force, are involved in costs ...
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95 Reducing Health Care Costs by Reducing the Need and ...
https://www.nejm.org/doi/full/10.1056/nejm199307293290506
Introduction · A Theoretical Solution -- Reducing the Need and Demand for Medical Services · The Potential for Reducing Demand · Much Disease Is ...
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96 We Can Reduce US Health Care Costs
https://www.amjmed.com/article/S0002-9343%2809%2901115-2/fulltext
A Price Waterhouse Coopers study reported that our complex, fragmented health care delivery system wastes $210 billion per year on unnecessary ...
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